Multicatheter hybrid breast brachytherapy: A potential alternative for patients with inadequate skin distance

Sushil Beriwal, Devin O'Brien-Coon, Hayeon Kim, Marsha Haley, Rakesh Patel, Rupak Das

Research output: Contribution to journalArticle

Abstract

Purpose: The purpose of this study was to determine whether the ClearPath (CP) multicatheter hybrid device was able to achieve acceptable dosimetry in patients in whom the proximity of the breast surgical cavity to the skin precluded treatment with intracavitary MammoSite (MS) brachytherapy. Methods and materials: The study consisted of 11 patients who had the MS catheter placed and who were subsequently not treated due to inadequate skin distance. A phantom scan of the CP multicatheter hybrid device was superimposed on the MS CT scan and a dosimetric comparison was performed. Results: The median MS balloon size, diameter, and minimum skin distance were 40 cc, 4.1 cm, and 5 mm, respectively. The D 90, V 100, V 150, and V 200 with MS vs. CP were 95.29% vs. 97.06%, 88.8% vs. 91.3%, 35.7% vs. 38.0%, and 9.4% vs. 9.6%, respectively. The median maximum skin dose was 5.5 Gy vs. 3.9 Gy (p <.0001). The median dose homogeneity index (DHI) was 0.60 vs. 0.59 (p = .09). The median maximum rib, heart, and lung dose were 2.17 Gy vs. 2.18 Gy, 2.17 Gy vs. 2.18 Gy, and 0.50 Gy vs. 0.56 Gy, respectively. Conclusion: The hybrid CP catheter reduced the skin dose significantly without compromising the planning target volume coverage, DHI, or dose to other critical organs. The use of this device has the potential to increase the applicability of accelerated partial breast brachytherapy (APBI) in patients with a surgical cavity close to skin compared with balloon brachytherapy.

Original languageEnglish (US)
Pages (from-to)301-304
Number of pages4
JournalBrachytherapy
Volume7
Issue number4
DOIs
StatePublished - Oct 1 2008
Externally publishedYes

Fingerprint

Brachytherapy
Breast
Skin
Equipment and Supplies
Catheters
Ribs
Lung

Keywords

  • APBI
  • ClearPath
  • MammoSite

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Multicatheter hybrid breast brachytherapy : A potential alternative for patients with inadequate skin distance. / Beriwal, Sushil; O'Brien-Coon, Devin; Kim, Hayeon; Haley, Marsha; Patel, Rakesh; Das, Rupak.

In: Brachytherapy, Vol. 7, No. 4, 01.10.2008, p. 301-304.

Research output: Contribution to journalArticle

Beriwal, Sushil ; O'Brien-Coon, Devin ; Kim, Hayeon ; Haley, Marsha ; Patel, Rakesh ; Das, Rupak. / Multicatheter hybrid breast brachytherapy : A potential alternative for patients with inadequate skin distance. In: Brachytherapy. 2008 ; Vol. 7, No. 4. pp. 301-304.
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abstract = "Purpose: The purpose of this study was to determine whether the ClearPath (CP) multicatheter hybrid device was able to achieve acceptable dosimetry in patients in whom the proximity of the breast surgical cavity to the skin precluded treatment with intracavitary MammoSite (MS) brachytherapy. Methods and materials: The study consisted of 11 patients who had the MS catheter placed and who were subsequently not treated due to inadequate skin distance. A phantom scan of the CP multicatheter hybrid device was superimposed on the MS CT scan and a dosimetric comparison was performed. Results: The median MS balloon size, diameter, and minimum skin distance were 40 cc, 4.1 cm, and 5 mm, respectively. The D 90, V 100, V 150, and V 200 with MS vs. CP were 95.29{\%} vs. 97.06{\%}, 88.8{\%} vs. 91.3{\%}, 35.7{\%} vs. 38.0{\%}, and 9.4{\%} vs. 9.6{\%}, respectively. The median maximum skin dose was 5.5 Gy vs. 3.9 Gy (p <.0001). The median dose homogeneity index (DHI) was 0.60 vs. 0.59 (p = .09). The median maximum rib, heart, and lung dose were 2.17 Gy vs. 2.18 Gy, 2.17 Gy vs. 2.18 Gy, and 0.50 Gy vs. 0.56 Gy, respectively. Conclusion: The hybrid CP catheter reduced the skin dose significantly without compromising the planning target volume coverage, DHI, or dose to other critical organs. The use of this device has the potential to increase the applicability of accelerated partial breast brachytherapy (APBI) in patients with a surgical cavity close to skin compared with balloon brachytherapy.",
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AB - Purpose: The purpose of this study was to determine whether the ClearPath (CP) multicatheter hybrid device was able to achieve acceptable dosimetry in patients in whom the proximity of the breast surgical cavity to the skin precluded treatment with intracavitary MammoSite (MS) brachytherapy. Methods and materials: The study consisted of 11 patients who had the MS catheter placed and who were subsequently not treated due to inadequate skin distance. A phantom scan of the CP multicatheter hybrid device was superimposed on the MS CT scan and a dosimetric comparison was performed. Results: The median MS balloon size, diameter, and minimum skin distance were 40 cc, 4.1 cm, and 5 mm, respectively. The D 90, V 100, V 150, and V 200 with MS vs. CP were 95.29% vs. 97.06%, 88.8% vs. 91.3%, 35.7% vs. 38.0%, and 9.4% vs. 9.6%, respectively. The median maximum skin dose was 5.5 Gy vs. 3.9 Gy (p <.0001). The median dose homogeneity index (DHI) was 0.60 vs. 0.59 (p = .09). The median maximum rib, heart, and lung dose were 2.17 Gy vs. 2.18 Gy, 2.17 Gy vs. 2.18 Gy, and 0.50 Gy vs. 0.56 Gy, respectively. Conclusion: The hybrid CP catheter reduced the skin dose significantly without compromising the planning target volume coverage, DHI, or dose to other critical organs. The use of this device has the potential to increase the applicability of accelerated partial breast brachytherapy (APBI) in patients with a surgical cavity close to skin compared with balloon brachytherapy.

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